As things continued, triage tags came out, and areas of the tent were designated for acuity with signs. Patients were arriving with triage designations written on their foreheads with marker. At the same time, less acute patients were lining up for transport. Overall, things were quickly getting organized. The medical tent was transformed from a high-performing sports medicine facility to an organized trauma repository managing injuries that I could not conceptualize prior to that day.

As the response progressed, we were afforded even more ambulances and were moving patients quicker. Then the influx of patients stopped almost as soon as it started. Fire, police, EMS, and volunteers had an amazing effort in bringing the patients to the tent amazingly fast.

A split second of change, or so it seemed, was now winding down almost as fast. We weren’t sure what to do next. We watched patients leave. Fear, uncertainty, and concern crept in. In the tent, all we knew was that two bombs exploded. Were there more? Were the police outside the tent? Was there a fire? What was going on in the rest of the nation or the world? All we knew was for the recent past we focused on every casualty coming through, blind to the bigger events just outside the thin white canvas walls.

When things started to wind down, people were dismissed through a newly created side door in the tent. As I walked out, a police officer said, “there will be a controlled detonation” and my heart stopped, and sure enough there was another explosion as we were walking out. It took away the fragile calm and forced us into the reality around us.

There was only one way to walk, from the tent and toward the Boston Commons. EMS, police, and fire were still actively running around outside the tent. It was abundantly clear this was still a dynamic situation. As we headed east, police and fire continued toward Copley Square. There was a large influx of manpower in such a brief time. Barricades were being moved, and streets were being closed.

As we headed out, the Medical Director for the BAA said, “There are still runners out there,” and he quickly made a plan to rendezvous in the Commons.

As we wandered through empty streets of Boston, punctuated only by the occasional piercing wail of sirens, we arrived at the Commons. There, a group of medical providers stood, waiting. The occasional text from a close friend in a medical tent on the race course was reassuring. There were at least areas west of the site still functioning. One of our friends reached into his bag and produced some tin foil wrapped goodness, homemade fruit bars. He had worked for years in the tent and noted at around 4 p.m., people get quite hungry after working all day.